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Emerg Med J. 2016 Nov;33(11):776-781. doi: 10.1136/emermed-2015-205107. Epub 2016 Aug 2.

Out-of-hospital cardiac arrest attended by ambulance services in Ireland: first 2 years' results from a nationwide registry.

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Discipline of General Practice, National University of Ireland Galway, Galway, Ireland.
School of Business and Economics, National University of Ireland Galway, Galway, Ireland.
School of Medicine, Emory University, Atlanta, USA.
Medical Directorate, National Ambulance Service, Naas, Ireland.
Department of Emergency Medicine, Cork University Hospital, Cork, Ireland.
Department of Public Health Medicine, Health Service Executive, Ballyshannon, Ireland.
EMS Support Unit, Dublin Fire Brigade, Dublin, Ireland.
School of Medicine, National University of Ireland Galway, Galway, Ireland.



National data collection provides information on out-of-hospital cardiac arrest (OHCA) incidence, management and outcomes that may not be generalisable from smaller studies. This retrospective cohort study describes the first 2 years' results from the Irish National Out-of-Hospital Cardiac Arrest Register (OHCAR).


Data on OHCAs attended by emergency medical services (EMS) where resuscitation was attempted (EMS-treated) were collected from ambulance services and entered onto OHCAR. Descriptive analysis of the study population was performed, and regression analysis was performed on the subgroup of adult patients with a bystander-witnessed event of presumed cardiac aetiology and an initial shockable rhythm (Utstein group).


3701 EMS-treated OHCAs were recorded for the study period (1 January 2012-31 December 2013). Incidence was 39/100 000 population/year. In the Utstein group (n=577), compared with the overall group, there was a higher proportion of male patients, public event location, bystander cardiopulmonary resuscitation (CPR) and early defibrillation. Median EMS call-response interval was similar in both groups. A higher proportion of patients in the Utstein group achieved return of spontaneous circulation (35% vs 17%) and survival to hospital discharge (22% vs 6%). After multivariate adjustment for the Utstein group, the following variables were found to be independent predictors of the outcome survival to hospital discharge: public event location (OR 3.1 (95% CI 1.9 to 5.0)); bystander CPR (2.4 (95% CI 1.2 to 4.9)); EMS response of 8 min or less (2.2 (95% CI 1.3 to 3.6)).


This study highlights the role of nationwide registries in quantifying, monitoring and benchmarking OHCA incidence and outcome, providing baseline data upon which service improvement effects can be measured.


cardiac arrest; prehospital care; resuscitation

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